1.Community-acquired bacteremia in Paediatrics:Epidemiology, aetiology and patterns of antimicrobial resistance in a tertiary care centre, Malaysia
Nor Azizah Abu ; Fadzilah Mohd Nor ; Mariam Mohamad ; Anis Siham Zainal Abidin ; Ariza Adnan ; Noor Shafina Mohd Nor ; A Anita Kaur
The Medical Journal of Malaysia 2016;71(3):117-121
Introduction: bacteremia continues to be one of the major
causes of morbidity and mortality despite the existence of
numerous antimicrobial agents. this study aimed to provide
a Malaysian perspective on paediatric community-acquired
bacteraemia based on the documentation of epidemiology
and antimicrobial profile of the isolated pathogens.
Method: A retrospective study was conducted by analysing
clinical details, blood cultures and antimicrobial
susceptibility testing results in children between the ages of
0 to 13 years old, who were admitted to selayang Hospital
over an 11-year period from 2001 until 2011. there were 222
bacteraemia cases and the median age was 11.7 months.
the highest number (39%) of bacteraemia cases occurred
between ages one month to one year. the three most
commonly isolated aetiological agents were
Staphylococcus aureus (17.1%), nontyphoidal Salmonella
(16.2%), and Streptococcus pneumoniae (12.6%). Almost 8%
of the Staphylococcus aureus isolates were methicillin
resistant, while nontyphoidal Salmonella (Nts) isolates
demonstrated 18.4%, 10.5% and 2.6% resistance towards
ampicillin, trimethoprim-sulfamethoxazole and ciprofloxacin
respectively. All Nts isolates were sensitive to ceftriaxone.
Streptococcus pneumoniae isolates showed 17.9%
resistance to penicillin. skin and soft tissue infections as
well as lower respiratory tract infections (63.2%) were the
main foci of infections in Staphylococcus aureus
bacteraemia. Acute gastroenteritis (80.0%) and pneumonia
(60.8%) were the main presentations of Nts and
Streptococcus pneumoniae bacteraemia respectively.
Overall mortality rate was 8.1%.
Conclusion: Knowledge on the local epidemiology and
antibiotic resistance pattern serves as a significant platform
in improving the empiric antibiotic therapy for patients with
community acquired bacteraemia.
Anti-Infective Agents
;
Bacteremia
2.Maternal Satisfaction Towards Intrapartum Care of Designated Healthcare Facilities and Its Associated Factors Among Postnatal Women Attending Klinik Kesihatan Salak
Fadzilah Mohamad ; Ping Yein Lee ; Maliza Mawardi
Malaysian Journal of Medicine and Health Sciences 2020;16(No.2):164-172
Introduction: The World Health Organization recommends evaluation of maternal satisfaction to improve quality of health care during childbirth. Dissatisfaction may lead to undesired outcomes such as unassisted homebirth and delay in seeking treatment. Determining the maternal satisfaction level and its associated factors may help to improve health care services and prevent negative implications to both mothers and infants. This study aimed to determine the maternal satisfaction towards intrapartum care of designated healthcare facilities and its associated factors among postnatal women. Methods: This was a cross-sectional study of postnatal women attended Klinik Kesihatan Salak from December 2017 to February 2018. Systematic random sampling with the ratio of 1:3 was applied to the eligible respondents. A self-administered questionnaire that include respondent’s socio-demographic characteristics and a validated 14-items Maternal Satisfaction with Hospital-based Intrapartum Care Scale was used. Data was analyzed using SPSS 23. Results: 274 respondents were recruited in this study. Overall, only 21.2% of respondents were satisfied with the intrapartum care given. The level of satisfaction was highest in interpersonal care domain (36.1%), followed by physical birth environment (34.3%) and the least satisfied was information and decision making domain (27.7%). Binary logistic regression showed that maternal satisfaction was significantly associated with place of birth (AOR (95% CI): 0.046 (0.183, 0.984)) and labour complications (AOR (95% CI): 3.387 (1.345, 8.528)). Conclusion: The overall maternal satisfaction towards intrapartum care was low and the information and decision-making domain appeared to be the least satisfied. Maternal satisfaction was associated with place of birth and labour complications. Therefore, health care providers should emphasize and improve the quality of services especially for this domain and to consider factor that contribute to dissatisfaction towards the intrapartum care.
3.A life-threatening condition—ruptured ectopic pregnancy with negative urine pregnancy test: A case report
Fadzilah Mohamad ; Ahmad Shuib Yahya ; Aneesa Abdul Rashid ; Navin Kumar Devaraj ; Abdul Hadi Abdul Manap
Malaysian Family Physician 2021;16(1):121-123
Ectopic pregnancy is an extra-uterine pregnancy and is a potentially life-threatening condition that can lead to death from intra-peritoneal hemorrhage. This case reports a rare occurrence of ruptured tubal pregnancy in which the patient presented early with abdominal pain and a negative urine pregnancy test but subsequently presented again with evidence of intra-peritoneal hemorrhage. A negative urine pregnancy test is often used to rule out pregnancy, but it is not 100% sensitive. Complete assessment is critical in this important diagnosis in order to plan for the appropriate emergency management.
4.Perception of nurses on the practice environment: Experience from Malaysia
Suhana Jawahir ; Nurul Nadiah Mohamad Anuar ; Siti Fadzilah Sheikh Abdullah ; Saraswathy Silvernayagam ; Ee Hong Tan
The Medical Journal of Malaysia 2021;76(1):73-79
Introduction: Positive professional practice environments
are crucial to safeguard a healthy and safe working
conditions for health workforce, including nurses; so as to
ensure provision of quality healthcare and safety of patient.
Methods: This was a cross-sectional study to assess
nurses’ perceptions towards nursing practice environment
and factors associated with their perceptions. A validated
Practice Environment Scale of the Nursing Work Index (PESNWI) questionnaire was administered to nurses working in
two Ministry of Health hospitals. The questionnaire
comprises of five subscales: Participation, Foundation,
Managers Support, Workforce Adequacy and
Physician/Nurse Relations. Mean scores of >2.50 were
considered as favourable, and ≤2.50 were considered as
unfavourable. Simple linear and multiple linear regression
analysis were employed to identify factors associated with
their perceptions. Analysis was carried out using STATA
version 14.0.
Results: A total of 366 respondents took part in the study,
with a response rate of 98.4%. Majority were working shift
(89.6%) and working extended hours (62.3%). In general, the
nursing practice environments were rated as favourable.
Overall mean score was 2.90±0.03 and four out of five
subscales’ mean scores were >2.50. Foundation for quality
nursing care was perceived as the most favourable
subscale, while workforce adequacy was perceived as the
least favourable. There were statistically significant
association between working extended hours, doing double
shift and working during day off with perceived
unfavourable workforce adequacy.
Conclusion: Nursing practice environment was perceived as
favourable in the studied hospitals. Policy makers, service
providers, and hospital managers could explore further on
human resource planning and management of nursing
personnel to tackle the issue of nurse staffing in the country.
5.Mothers’ Perceptions and Experiences on Tongue-tie and Frenotomy: A Qualitative Study
Nor Asilah Harun ; Noor Arisa Mohamad Rashidi ; Nur Fadzilah Md Teni ; Yunita Dewi Ardini ; Nurjasmine Aida Jamani
Malaysian Journal of Medicine and Health Sciences 2022;18(No.2):6-13
Introduction: Tongue-tie is a congenital condition of a thickened, tightened or shortened frenulum. This condition
may cause breastfeeding difficulties to both mother and infant, such as ineffective suckling and painful nipple. In
older children, it can cause speech difficulties. Although many studies have investigated the problems associated
with tongue-tie and its treatments, there are limited studies on the mother’s experiences of tongue-tie and post frenotomy. This study aimed to explore the mother’s experiences of tongue-tie associated problems, frenotomy and the
outcome. Methods: In-depth interviews were conducted in a one-on-one setting with fifteen mothers whose infant
and children underwent frenotomy. Data were collected, transcripted, translated and analysed according to themes.
Results: The analysis revealed a common story of stressful challenges and difficulties of breastfeeding. The mothers
described that tongue-tie caused poor latching, nipple pain and bleeding, prolong feeding and lack of sleep. Their
infant had poor weight gain, sleeping problems, insufficient milk transfer, fatigue and constant crying. For the older
children, mothers complained of restricted tongue movement, difficulty in licking ice cream and speech problems.
All of them agreed that the frenotomy procedure was easy, simple and less invasive and the outcome was positive.
Furthermore, mothers continued breastfeeding without any difficulties and complications. Conclusion: Mothers in
this study had difficulties with breastfeeding. However, all of the reported symptoms improved after frenotomy. They
considered frenotomy was a simple and safe procedure that was highly recommended for symptomatic tongue-tie.
6.Prevalence of Burnout and Its Associated Factors among Medical Students in a Public University in Selangor, Malaysia: a CrossSectional Study
Hui Zhu Thew ; Siew Mooi Ching ; Nurin Amalina Sallahuddin ; Puteri Nur Dayana Nooralirakiz ; Thessa Sharmila David ; Imran Kamal Hafiz Zaidi ; Navin Kumar Devaraj ; Kai Wei Lee ; Hanifatiyah Ali ; Abdul Hadi Abdul Manap ; Fadzilah Mohamad ; Subapriya Suppiah ; Vasudevan Ramachandran
Malaysian Journal of Medicine and Health Sciences 2023;19(No.1):197-204
Introduction: Burnout is a growing trend among medical students worldwide. The aim of this study was to determine the prevalence and factors associated with burnout among medical students at a public university in Malaysia.
Methods: A cross-sectional study was conducted among 1st through 5th year medical students at a public university
using a simple random sampling method in recruiting participants. In this study, The Maslach Burnout Inventory-General Survey for Student (MBI-SS) was used and burnout is defined as severely emotionally exhausted and
severely depersonalised. Results: A total of 328 medical students were recruited with a with response rate of 88.6%.
The burnout prevalence was 10.1%. Based on multivariate logistic regression, presence of smartphone addiction
with adjusted (odds ratio (OR) 7.37, 95% confidence interval (CI) = 1.67, 32.49), course choice not based on personal interest or due to family pressure (OR 2.72, 95% CI = 1.08, 6.85) and the presence of family relationship problems (OR = 3.58, 95% CI = 1.27, 10.04) are more likely to be associated with burnout among the medical students.
Conclusion: Our study has shown that every tenth medical students suffers from burnout. Medical students who are
addicted to smartphone, have chosen medical course against individual interest or because of family pressure and
have family relationship problems are at risk of getting burnout. Intervention is required to address this issue for the
future well-being of medical students.